Objective To explore the clinical effect of IPL combined with tranexamic acid in the treatment of chloasma.Methods 50 patientss with chloasma were selected,and they were randomly divided into two groups by odd-and-even grouping method.The control group received IPL treatment,the study group was given photorejuvenation combined with tranexamic acid treatment.The MASI score,clinical efficacy and adverse reactions were compared between the two groups.Results The MASI score[(8.71 ± 0.82) points] and the total effective rate (92.00％) of the study group were significantly better than those of the control group [(11.35 ± 1.03) points,68.00％,t =3.10,x2 =4.39,all P ＜ 0.05].The incidence rate of adverse reaction betweem the two groups (16.00％,16.00％) had no significant difference (x2 =0.00,P ＞ 0.05).Conclusion Photorejuvenation combined with tranexamic acid has significant clinical effect in the treatment of chloasma.

Purpose:To analyze the CT appearances and diagnostic value of inflammatory pseudotumor of the liver(IPL)_O Materials and Methods: The CT findings of 19 patients with inflammatory pseudotumor of the liver proved by pathology were analyzed respectively.Results: 17 cases were solitary lesion and 2 cases had multiple lesions.19 lesions showed hypodense,2 lesions isodense on pre-contrast.On the contrast CT scan,showed no enhancement during arterial phase,but during portal venous phrase and delayed phase,strong enhancement at the edge and septa in the center or mural node,of the lesions were visible.Conclusion: CT diagnosis is possible in most cases of IPL by three phase dynamic scanning.

Objective　To investigate the effect of mifepristone on the expression of tumor necrosis factor-α（TNF-α） and transforming growth factor-β（TGF-β）in decidua of early pregnancy. Methods　Thirty artificial abortion women as control and thirty drug abortion women were enrolled for study. The expressions of TNF-α and TGF-β in decidua were measured with immunohistochemical method. Results　There was no significant difference of TNF-α positive expression rates between drug abortion group (73.33%) and artificial abortion group (70.00%，P>0.05). TGF-β expression rate of drug abortion group was similar to that of artificial abortion group. The highly-positive (+　+ and +　+　+) TNF-α expression rate in drug abortion group was significantly higher than that in artificial abortion group (P<0.05). TGF-β expression degree in decidua of drug abortion group was significantly lower than that of artificial abortion group (P<0.05). The ratio of TNF-α/TGF-β in drug abortion group is higher than that in artificial abortion group. Conclusion　TGF-β has great effect on regulating the embryo development of early pregnancy. The change of TNF-α may be the reason of abortion. Mifepristone may interfere with embryo growth by inhibiting the activity of TGF-β or by stimulating the secretion of TNF-α.

Objective The retrospective analysis was carried out to evaluate the results of humeral intercondylar fracture treated with AO reconstruction plate internal fixation accompanied by anterior transposition of the ulnar nerve. Methods From March 1996 to September 2001, sixty-eight patients diagnosed as humeral intercondylar fractures were treated in our hospital, forty-three of which were followed up and evaluated. By AO/ASIF classification, there were type C1 in 14 cases, type C2 in 18 cases, and type C3 in 11 cases. There were 18 male and 15 female patients with an average of 41 years ranging from 18 to 65 years. The patients were open fracture in 7 cases and closed fracture in 36 cases, of which were associated with humeral shaft fracture in 4 cases, Colles fracture in 5 cases, Monteggia fracture in 3 cases, olecranon fracture in 5 cases, and ulnar nerve injury in 6 cases. They were treated with open reduction and AO reconstruction plate internal fixation combined with routine anterior transposition of the ulnar nerve followed by early CPM mobilization. Results The mean follow-up of the group was 17.7 months ranging 12 to 37 months with bone union in 12 to 18 weeks. The outcome was evaluated with Aitken-Rorabeck rating system, 33 of which were graded as excellent, 4 cases as good, 5 cases as fair, 1 case as poor, as a result, the elbow function was excellent to good in 86.1%. One case experienced three degrees cubital varus without an influence on function of the elbow. The wound infection occurred in three cases healed following dress change. A heterotopic ossification developed in two cases 4 weeks later after operation. The preoperative ulnar nerve palsy recovered in all 6 cases, and there was no delayed ulnar nerve palsy happened postoperatively. Two elbow joints were restricted during extension to flexion activity by 43 degrees and 62 degrees respectively. Conclusion Intercondylar fractures of the distal humerus should be treated surgically as early as possible. Anatomical reduction, rigid fixation and early CPM exercise are the key prognostic factors, which could improve the elbow function. Otherwise routine anterior transposition of the ulnar nerve may be helpful to reduce the incidence of delayed ulnar nerve palsy.

Objective To investigate the relation between CD44v6 and lymph node metastasis and prognosis of gastric carcinoma. Methods The expression of CD44v6 in 100 cases of advanced human gastric carcinoma was detected by immunohistochemical two-step method. Its relation with clinical pathology and prognosis was analyzed. Results CD44v6 expression occurred in 64%(64/100) of all gastric carcinomas; with the increase of depth of cancer invasion and local lymph node metastasis, the expression of CD44v6 elevated. Conclusion CD44v6 plays an important role in lymph node metastasis of human gastric carcinoma. It may be used as a new indicator to predict metastatic potential and prognosis of gastric carcinoma.

Purpose To evaluate 1H proton magnetic resonance spectroscopy (1H-MRS) in detecting traumatic brain injury (TBI) and its metabolic changes during the initial two weeks after trauma using rabbit modes. Materials and Methods Fifteen Chinese rabbits were randomly divided into sham control group (n=5) and TBI group (n=10), 1H-MRS was performed 1 hour, 6 hours, 24 hours and 2 days, 7 days, 14 days after trauma, the concentration of N-acetylaspartate (NAA), creatine (Cr), choline-compound (Cho), NAA/Cr and Cho/Cr in each group was evaluated. At 6 hours, 24 hours and 168 hours after injury, 1 rabbit was slaughtered after abdominal anesthesia at each time point, the sample was ifxed with left heart catheterization perfusion after death, brain tissue was obtained, blocked, dehydrated into frozen section, HE staining was used for observation. Results Compared with the control group, NAA/Cr ratio in the trauma region decreased by 29%1 hour after trauma, with maximal reduction of 40% (at 24 hours) before increasing slightly, the NAA/Cr ratio returned to control level gradually until 168 hours later. The Cho/Cr ratio decreased by 16% 1 hour after trauma, with maximal reduction of 30%(at 6 hours) and increased gradually until finally su rpassed control level (168 hours) for 20% and then became stable. NAA/Cr ratio and Cho/Cr ratio showed statistically significant changes between each observing time point (P<0.05). Conclusion 1H-MRS can be used for dynamic detection of cerebral metabolism without injury, and is superior to MRI in detecting early abnormality of the brain, with NAA/Cr as the most sensitive parameter. Detecting the changes of NAA/Cr, Cho/Cr ratios in the trauma region can be used as a guide for assessment of the clinical treatment effectiveness of TBI.

0 05). TGF ? expression rate of drug abortion group was similar to that of artificial abortion group. The highly positive (++ and +++) TNF ? expression rate in drug abortion group was significantly higher than that in artificial abortion group ( P

Objective To study the correlation of the number and ratio of involved lymph nodes and the prognosis of gastric carcinoma .Methods 174 patients with positive gastric lymph nodes were included,they were treated by radical gastrectomy and lymph nodes dissection (D2 or D3)in our department. The number and ratio of metastastic gastric lymph nodes were calculated. Their influence and their interrelation with pathogenic parameters were analyzed. Results The overall 5 year survival rate was 29.59%, and the five year survival rates of patients with 1 20 per cent and more than 20% positive lymph nodes were 70.58%,11.86% respectively, one to five positive lymph nodes and five more were 46.47%,17.35% respectively, the five year survival rate was decreased as the ratio and number of involved lymph nodes increased. Studies also indicated that with the increase of depth of cancer invasion ,the number and ratio of involved lymph node elevated.Conclusions The results shows that the number and ratio of involved lymph nodes correlated to tumour progression and the five survival rate.Perigastric lymph node status can be considered as a simple and effective prognosis factor.

Objective To summarize the experience of diagnosis and management of bleeding with GIVM.Method The clinical data of 26 patients admitted from 1989 to 1999 were analyzed retrospectively.Results GIVM with bleeding were revealed by endoscopies (42%),by ECT (55%),by selective arteriography (83%),by barium radiography (0%),and by exploratory laparotomy(100%).1 case was cured by conservative treatment.Bleeding intestinal segment was resected in 14 cases.4 cases were cured by interventional therapy.The others were cured by sclerosing agent injection,or by suture ligation of the dilated vessel or arterial gastroduodenalis.Conclusions Endoscopy is the first choice in the bleeding from GIVM.ECT may beused later if endoscopy is useless.Selective arteriography is the most valuable method in GIVM diagnosis.If necessary, exploratory laparotomy and intraoperative endoscopies may be used.Resecting bleeding segment is the most effective treatment.Other methods such as interventional therapy and suture ligation of dilated vessel are also effective.

Objective:To observe the effects of ultrasound-guided paravertebral nerve block combined with general anesthesia on intraoperative stress response, hemodynamics and postoperative pain of patients undergoing laparoscopic cholecystectomy.Methods:A total of 92 patients undergoing elective laparoscopic cholecystectomy in Wuhan Third Hospital between January 2017 and August 2019 wereselected. They were divided into the control group (63 cases) and the observation group (29 cases) by voluntary. The control group were given simple general intravenous anesthesia, and the observation group were given ultrasound-guided paravertebral nerve block combined with general intravenous anesthesia. Changes in hemodynamic parameters and concentrations of blood angiotensin-Ⅱ (AT-Ⅱ) and cortisol (Cor) in the two groups were observed. The cerebral state indexes (CSI) of both groups were recorded, and pain degree of patients was evaluated with the visual analogue scale (VAS).Results:The mean arterial pressure (MAP) and heart rate (HR) of the observation group were higher than those of the control group at 30 min after anesthesia, 30 min after operation, 3 hours after operation ( P<0.05), the stroke volume variation (SVV) was lower than that of the control group ( P<0.05); the AT-Ⅱ, Cor and CSI in the observation group were lower than those in the control group at each time point ( P<0.05); The dosage of narcotic drugs in the observation group was significantly lower than that in the control group ( P<0.05); The recovery time of spontaneous breathing, recovery time, extubation time and respiratory satisfaction time in the observation group were less than those in the control group ( P<0.05), and the VAS scores at 3 h, 6 h and 12 h after operation in the observation group were lower than those in the control group ( P<0.05). Conclusions:Ultrasound-guided paravertebral nerve block combined with general anesthesia can effectively reduce the patient's stress response during laparoscopic cholecystectomy, with good analgesic effect, which is helpful to maintain the hemodynamic stability of patients.